徐笑挺^1,2,,
戴承晔^1,2,
邓毅凡²,
何胜虎²,
张晶^2,,
1. 大连医科大学 扬州临床医学院，江苏 扬州 225001
2. 江苏省苏北人民医院 心内科，江苏 扬州 225001

基金项目: 江苏省卫生健康委员会科研课题（Z2018032）；扬州市重点研发（社会发展）项目（YZ2020103）


详细信息 作者简介: 徐笑挺（1996-），男，硕士研究生。E-mail：xu2060066502@163.com





通讯作者: 张 晶，副主任医师。E-mail：zhangjingyjs@163.com 中图分类号: R541.4


摘要:目的探讨急性ST段抬高型心肌梗死（STEMI）患者急诊介入术后血清低密度脂蛋白胆固醇（LDL）与高密度脂蛋白胆固醇（HDL）比值和主要不良心血管事件（MACE）的关系。方法纳入2019年8月至2020年8月住院的STEMI同时行急诊PCI的患者63例，所有患者均按二级预防标准调脂治疗1个月，根据LDL/HDL的中位数（1.40）将研究人群分为高LDL/HDL组31例和低LDL/HDL组32例，比较两组间MACE发生率及实验室指标，分析标准调脂1个月后的LDL/HDL与术后12个月内发生MACE的关系。结果高LDL/HDL组比低LDL/HDL组具有更高的MACE发生率（P＜0.05），Cox多因素回归分析显示LDL/HDL（HR=7.07，P=0.031）是独立预测MACE发生的危险因素。LDL/HDL预测MACE的AUC为 0.757（P＜0.01）。结论LDL/HDL是STEMI患者急诊介入术后发生MACE的独立危险因素，监测LDL/HDL并有针对性进行干预有助于减少不良心血管事件，值得推广应用。
关键词: LDL与HDL比值/
急性ST段抬高型心肌梗死/
急诊介入/
主要不良心血管事件


Abstract:ObjectiveTo study the correlation of lipoprotein cholesterol (LDL)/high-density lipoprotein cholesterol (HDL) ratio with major adverse cardiovascular events (MACE) in patients with ST segment elevation myocardial infarction (STEMI) after emergency percutaneous coronary intervention (PCI). MethodsA total of 63 STEMI patients with emergency PCI hospitalized from August 2019 to August 2020 were selected. All patients were treated with secondary prevention standards for lipid-lowering treatment for one month. According to the median of LDL/HDL (1.40), the patients were divided into high LDL/HDL group (31 cases) and low LDL/HDL group (32 cases). The incidence of MACE and laboratory indicators were compared between the two groups, and the relationship between LDL/HDL after one month of standard lipid-lowering therapy and the occurrence of MACE within 12 months after surgery was analyzed. ResultsThe high LDL/HDL group had a higher incidence of MACE than the low LDL/HDL group (P＜0.05). Cox multivariate regression analysis showed that LDL/HDL (HR=7.07, P=0.031) was an independent risk factor for the occurrence of MACE. The AUC of LDL/HDL to predict MACE was 0.757 (P＜0.01). ConclusionLDL/HDL ratio is an independent risk factor for MACE after emergency intervention in STEMI patients. Monitoring LDL/HDL and targeted intervention would reduce adverse cardiovascular events, and be worthy of promotion and application.
Keywords:LDL/HDL ratio/
ST segment elevation myocardial infarction/
emergency percutaneous coronary intervention/
MACE

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